Adoption Application

Name of the dog(s) you are interested in:*

Your name:*

First NameLast Name

Date of Birth (mm/dd/yyyy):*

Email:*

example@example.com

Primary Phone Number:*

Please enter a valid phone number.Format: (000) 000-0000.

Preferred method of communication:*

CallTextEmail

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please list Facebook or social media handle to verify identity

Do you live in a:*

Do you:*

RentOwn

If renting, please provide the landlord's name and contact information:

If renting, are there any pet restrictions where you live? (Additional deposit, weight restrictions, breed restrictions, etc)

Describe your household activity level:*

Busy with lots of coming and goingModerate activity levelQuiet with occasional guests

Please list all humans living in the home, including age:*

Please list all animals currently living in the home. *Please include age, species/breed, and approximate weight:*

If no current pets, please enter N/A

If you currently own pets, are they all spayed/neutered?*

YesNoNo current pets

If no, please explain why:

If you currently own pets, are they up to date on vaccinations?*

YesNoNo current pets

If no, please explain why:

If you currently own pets, are they on monthly heartworm, flea, and tick prevention?*

YesNoNo current pets

If no, please explain why:

Please list any previous pets you have had within the past 5 years. *Please include age, species/breed, if spayed/neutered:*

If no previous pets within the past 5 years, please enter N/A

What was the outcome of the pets you no longer have?*

If no previous pets within the past 5 years, please enter N/A

Are all family members in agreement in the decision to adopt a dog?*

YesNo

Have you ever given up a pet?*

YesNo

If yes, please explain why:

Are you willing and able to give medication to a dog if needed?*

YesNo

We cannot guarantee that all dogs will be housebroken- are you willing and able to potty train a dog if needed?*

YesNo

Do you have any prior experience with a dog who has been abused/neglected/mistreated in the past?*

YesNo

Do you have a fenced yard?*

YesNo

If yes, please describe the size of the yard, fence material, and height of fence:*

If no, how do you plan on keeping the pet secure when outdoors?*

Where will your dog spend the majority of his/her time?*

IndoorsOutdoors

How many hours a day will your dog be left alone on average?*

Where will your dog stay when you are not home?*

Where will your dog sleep?*

What is your contingency plan in the event that you are no longer able to take care of your adopted dog(s)?*

Self or family member will contact us to surrender the dog back to Foster Doc Houston Dog RescueTrusted family member or friend will assume legal guardian/ownership of the dog, contacting us for approval of this transfer

Should your adopted dog require humane euthanasia for any reason (including but not limited to untreatable/deteriorative health problems, old age, irreperable injury, etc), do you agree to contact us prior to physically taking your adopted dog to the vet to complete this service? (excluding emergent situations, in which we should be contacted shortly after the fact.)*

Do you understand that new circumstances can be potentially very challenging for newly adopted dogs and are you willing to work through these challenges with patience and understanding?*

Please provide the contact information of your veterinarian. Please also make sure to contact your veterinarian shortly after submitting this application to approve vet checks. ***If you do not have any current pets, please provide the contact information of the veterinarian you plan to use:*

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the denial of adoption or forfeiture of any Foster Doc Houston Dog Rescue animal adopted by me.

I certify that the above information is correct, and I understand that the information will be verified.

I agree to have Foster Doc Houston Dog Rescue complete reference call checks and conduct a home visit inspection and/or home facetime to be able to approve my application.

Date of submission*

Date

Signature*